Osteoporosis (OP) is a common chronic metabolic bone disease characterized by decreased bone mineral content and microstructural damage, leading to increased fracture risk. Traditional methods for measuring bone density have limitations in accurately distinguishing vertebral bodies and are influenced by vertebral degeneration and surrounding tissues. Therefore, novel methods are needed to quantitatively assess changes in bone density and improve the accurate diagnosis of OP. This study aimed to explore the applicative value of the iterative decomposition of water and fat with echo asymmetry and least-squares estimation-iron (IDEAL-IQ) sequence combined with intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) for the diagnosis of osteoporosis. Data from 135 patients undergoing dual-energy X-ray absorptiometry (DXA), IDEAL-IQ, and IVIM-DWI were prospectively collected and analyzed. Various parameters obtained from IVIM-DWI and IDEAL-IQ sequences were compared, and their diagnostic efficacy was evaluated. Statistically significant differences were observed among the three groups for FF, R2*, f, D, DDC values, and BMD values. FF and f values exhibited negative correlations with BMD values, with r=-0.313 and − 0.274, respectively, while R2*, D, and DDC values showed positive correlations with BMD values, with r = 0.327, 0.532, and 0.390, respectively. Among these parameters, D demonstrated the highest diagnostic efficacy for osteoporosis (AUC = 0.826), followed by FF (AUC = 0.713). D* exhibited the lowest diagnostic performance for distinguishing the osteoporosis group from the other two groups. Only D showed a significant difference between genders. The AUCs for IDEAL-IQ, IVIM-DWI, and their combination were 0.74, 0.89, and 0.90, respectively. IDEAL-IQ combined with IVIM-DWI provides valuable information for the diagnosis of osteoporosis and offers evidence for clinical decisions. The superior diagnostic performance of IVIM-DWI, particularly the D value, suggests its potential as a more sensitive and accurate method for diagnosing osteoporosis compared to IDEAL-IQ. These findings underscore the importance of integrating advanced imaging techniques into clinical practice for improved osteoporosis management and highlight the need for further research to explore the full clinical implications of these imaging modalities. IVIM-DWI’s Diagnostic Value: IVIM-DWI, especially its parameter D, showed high efficacy for osteoporosis diagnosis. Its ability to separate diffusion from microcirculatory perfusion offers advantages over traditional methods like DXA, potentially enabling earlier and more precise detection of osteoporosis and guiding timely interventions. Superiority of IVIM-DWI: IVIM-DWI outperformed IDEAL-IQ in osteoporosis diagnosis. Its capability to provide comprehensive information about bone density and microstructural changes makes it a valuable addition to imaging protocols, aiding clinicians in making more informed decisions and personalized treatment plans. Demographic Influences: Significant differences in imaging parameters were observed between genders and age groups. Understanding these demographic influences can enhance the interpretation of imaging data, guiding tailored management strategies for specific patient populations and potentially shedding light on the underlying mechanisms of osteoporosis.

中文翻译：

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IDEAL-IQ联合体素内不相干运动扩散加权成像定量诊断骨质疏松


骨质疏松症（OP）是一种常见的慢性代谢性骨病，其特征是骨矿物质含量减少和微结构损伤，导致骨折风险增加。传统的骨密度测量方法在准确区分椎体方面存在局限性，并且受到椎体退变和周围组织的影响。因此，需要新的方法来定量评估骨密度的变化并提高OP的准确诊断。本研究旨在探讨回波不对称和最小二乘估计铁（IDEAL-IQ）序列迭代分解水和脂肪结合体素内不相干运动扩散加权成像（IVIM-DWI）在诊断中的应用价值骨质疏松症。前瞻性收集和分析了 135 名接受双能 X 射线吸收测定法 (DXA)、IDEAL-IQ 和 IVIM-DWI 患者的数据。比较 IVIM-DWI 和 IDEAL-IQ 序列获得的各种参数，并评估其诊断效果。三组之间的 FF、R2*、f、D、DDC 值和 BMD 值存在统计学显着差异。 FF和f值与BMD值呈负相关，r分别为-0.313和-0.274，而R2*、D和DDC值与BMD值呈正相关，r分别为0.327、0.532和0.390。在这些参数中，D 对骨质疏松症的诊断功效最高（AUC = 0.826），其次是 FF（AUC = 0.713）。 D* 在区分骨质疏松症组与其他两组时表现出最低的诊断性能。只有D显示出性别之间的显着差异。 IDEAL-IQ、IVIM-DWI 及其组合的 AUC 分别为 0.74、0.89 和 0.90。 IDEAL-IQ结合IVIM-DWI为骨质疏松症的诊断提供了有价值的信息，并为临床决策提供了依据。 IVIM-DWI 卓越的诊断性能，特别是 D 值，表明与 IDEAL-IQ 相比，它有可能成为诊断骨质疏松症更灵敏、更准确的方法。这些发现强调了将先进成像技术融入临床实践以改善骨质疏松症管理的重要性，并强调需要进一步研究以探索这些成像方式的完整临床意义。 IVIM-DWI的诊断价值：IVIM-DWI，特别是其参数D，对骨质疏松症的诊断具有较高的功效。其将扩散与微循环灌注分开的能力比 DXA 等传统方法具有优势，有可能实现更早、更精确的骨质疏松症检测并指导及时干预。 IVIM-DWI的优越性：IVIM-DWI在骨质疏松诊断方面优于IDEAL-IQ。它能够提供有关骨密度和微观结构变化的全面信息，使其成为成像方案的宝贵补充，帮助临床医生做出更明智的决策和个性化治疗计划。人口影响：在性别和年龄组之间观察到成像参数存在显着差异。了解这些人口统计影响可以增强对影像数据的解释，指导针对特定患者群体的定制管理策略，并有可能揭示骨质疏松症的潜在机制。